9亚低温技术在心肺复苏中的应用陆一鸣.pptxVIP

亚低温技术在心肺复苏中的应用Therapeutic hypothermia in post-resuscitation patients;提纲;猝死病人死亡率近70% ;心脏骤停的流行病学 ;Mry Ann Peberdy, Joseph P Ornato;低温治疗的分类;低温治疗作用机制;低温治疗作用机制的新观念;Bladder Temperature in the Normothermia and Hypothermia Groups. The T bars indicate the 75th percentile in the normothermia group and the 25th percentile in the hypothermia group. The target temperature in the hypothermia group was 32℃ to 34 ℃, and the duration of cooling was 24 hours. Only patients with recorded temperatures were included in the analysis.;After 6 months: 75 of the 136 (55%) in hypothermia group had better favorable neurologic outcome than normothermia group (39%).;After 6 months: Rate of death (41%) in the hypothermia is 14% lower than in the normothermia group (39%). ;欧洲多中心临床试验（ HACA trial);;澳大利亚的研究;Preliminary evidence in patients with asystole/PEA…;欧洲HART Study - ICY 在心脏骤停的多中心试验 ;;Before- and after comparison in 665 out-of hospital cardiac arrest in the Stavanger area (population 300 000) 2001-2003;Before- and after comparison in 665 out-of hospital cardiac arrest in the Stavanger area (population 300 000) 2001-2003;Cooling Procedure ;All patients in the database from August 1991 to November 2004 were screened. For outcome evaluation all patients who were cooled with endovascular cooling during this period were evaluated. For evaluation of cooling rate we restricted the analysis to patients who received endovascular cooling exclusively. ;Bladder temperature course. Median, 25th and 75th quartile of bladder temperature after return of spontaneous circulation in patients, who were exclusively cooled with the endovascular cooling device (n=56). Target temperature, 33°C; cooling duration, 24 hours. ;Adverse Event ;Methods -- Consecutive comatose survivors of cardiac arrest, who were either cooled for 24 hours to 33°C with endovascular cooling or treated with standard postresuscitation therapy, were analyzed. Complication data were obtained by retrospective chart review. Results -- Patients